THE EFFECTIVENESS OF CLOSED WEDGE FEMORAL OSTETOMY IN CORRECTION OF GENU VALGUM DEFORMITY IN ADOLESCENT.

Abstract

Background: Various types of corrective osteotomies of the distal femur have been described in the literature
for genu valgum deformity such as lateral opening wedge, medial closing wedge, dome osteotomy, wedgeless
spike osteotomy, and wedgeless “V” osteotomy. Objectives: We aimed this study to evaluate the effectiveness
of medial closing wedge osteotomy in correction of deformity. Methods: In this study, after recording history
and physical examination, appropriate radiographs were taken. We did varus distal femoral osteotomy by
standard medial subvastus approach then followed the patients clinically and radiographically. Results: This
study was done on 32 knees (18 patients) age was ranged from 10 to 18 years with mean average of (15.61±1.28)
years. Operation time was distributed as 139.72±42.4 minutes, with minimum 90 minutes and maximum 170
minutes. The mean time to union of osteotomy was 8.9weeks ranged (7-11 weeks). The mean preoperative
tibiofemoral angle (TFA) was 16.5° (range, 12°–19°) that improved after surgery to a mean postoperative value
of 2.57° (range, 1.3°–4.7°) which was statistically significant (P < 0.001). Conclusion: Distal femoral varus
osteotomy can be a reliable procedure for the treatment of valgus knee deformity. In this procedure, with more
tibiofemoral angle correction, more congruence angle correction can be achieved. Therefore, along with genu
valgum correction, the patella should be stabilized simultaneously.